Heres, Stephan, Cordes, Joachim, Feyerabend, Sandra, Schmidt-Kraepelin, Christian, Musil, Richard, Riedel, Michael, Spellmann, Ilja, Langguth, Berthold, Landgrebe, Michael, Fran, Elmar, Petcu, Camelia C., Hahn, Eric ORCID: 0000-0002-3782-1983, Ta, Tam M. T., Matei, Valentin ORCID: 0000-0001-6255-3100, Dehelean, Liana, Papava, Ion, Leweke, F. Markus, van der List, Till, Tamasan, Simona C., Lang, Fabian U., Naber, Dieter, Ruhrmann, Stephan ORCID: 0000-0002-6022-2364, Wolff-Menzler, Claus, Juckel, Georg, Ladea, Maria, Stefanescu, Cristinel, Lautenschlager, Marion, Bauer, Michael, Zamora, Daisy, Horowitz, Mark ORCID: 0000-0002-0061-8586, Davis, John M. and Leucht, Stefan ORCID: 0000-0002-4934-4352 (2022). Changing the Antipsychotic in Early Nonimprovers to Amisulpride or Olanzapine: Randomized, Double-Blind Trial in Patients With Schizophrenia. Schizophr. Bull., 48 (6). S. 1273 - 1284. OXFORD: OXFORD UNIV PRESS. ISSN 1745-1701

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Abstract

Background and Hypothesis Meta-analyses have shown that the majority of patients with schizophrenia who have not improved after 2 weeks of treatment with an antipsychotic drug are unlikely to fully respond later. We hypothesized that switching to another antipsychotic with a different receptor binding profile is an effective strategy in such a situation. Study Design In total, 327 inpatients with an acute exacerbation of schizophrenia were randomized to double-blind treatment with either olanzapine (5-20 mg/day) or amisulpride (200-800 mg/day). Those patients who had not reached at least 25% Positive-and-Negative-Syndrome-Scale (PANSS) total score reduction from baseline after 2 weeks (the non-improvers) were rerandomized double-blind to either staying on the same compound (stayers) or to switching to the other antipsychotic (switchers) for another 6 weeks. The primary outcome was the difference in the number of patients in symptomatic remission between the combined switchers and the stayers after 8 weeks of treatment, analyzed by logistic regression. Study Results A total of 142 nonimprovers were rerandomized at week two. 25 (45.5 %) of the 'stayers' compared to 41 (68.3 %) of the switchers reached remission at endpoint (p = .006). Differences in secondary efficacy outcomes were not significant, except for the PANSS negative subscore and the Clinical-Global-Impression-Scale. Switchers and stayers did not differ in safety outcomes. Conclusions Switching non-improvers from amisulpride to olanzapine or vice-versa increased remission rates and was safe. The superiority in the primary outcome was, however, not paralleled by significant differences in most secondary efficacy outcomes and the effect was only apparent at the last visit making replications of longer duration necessary.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Heres, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cordes, JoachimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Feyerabend, SandraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmidt-Kraepelin, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Musil, RichardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Riedel, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Spellmann, IljaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Langguth, BertholdUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Landgrebe, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fran, ElmarUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Petcu, Camelia C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hahn, EricUNSPECIFIEDorcid.org/0000-0002-3782-1983UNSPECIFIED
Ta, Tam M. T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Matei, ValentinUNSPECIFIEDorcid.org/0000-0001-6255-3100UNSPECIFIED
Dehelean, LianaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Papava, IonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Leweke, F. MarkusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van der List, TillUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tamasan, Simona C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lang, Fabian U.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Naber, DieterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ruhrmann, StephanUNSPECIFIEDorcid.org/0000-0002-6022-2364UNSPECIFIED
Wolff-Menzler, ClausUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Juckel, GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ladea, MariaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stefanescu, CristinelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lautenschlager, MarionUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bauer, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zamora, DaisyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Horowitz, MarkUNSPECIFIEDorcid.org/0000-0002-0061-8586UNSPECIFIED
Davis, John M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Leucht, StefanUNSPECIFIEDorcid.org/0000-0002-4934-4352UNSPECIFIED
URN: urn:nbn:de:hbz:38-697667
DOI: 10.1093/schbul/sbac068
Journal or Publication Title: Schizophr. Bull.
Volume: 48
Number: 6
Page Range: S. 1273 - 1284
Date: 2022
Publisher: OXFORD UNIV PRESS
Place of Publication: OXFORD
ISSN: 1745-1701
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
SCALE; DRUG; IMPROVEMENT; RELIABILITY; RISPERIDONE; ANTAGONIST; REMISSION; WELLMultiple languages
PsychiatryMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69766

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